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Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUTH A SKIDMORE (CEO)
(707) 573-6925
Entity
Organization
Contact information
Practice address
3536 MENDOCINO AVE STE 300, SANTA ROSA, CA 95403-3634
(707) 544-3811
(707) 544-0128
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 573-6918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811163934
—
CA
01
—
CN8040
RAILROAD MEDICARE
CA
01
—
ZZZ53246Y
BS OF CALIFORNIA
CA
Enumeration date
05/08/2008
Last updated
03/20/2019
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